It has been confirmed that Clinical Commissioning Groups (CCGs) are now able to set the time that individuals have to challenge an eligibility decision for NHS Continuing Healthcare.

In the past, people were allowed six months to request Local Resolution – the first stage of the appeal process – according to nationally-set rules.

Now, local decision-makers can choose and fix that period in their area – the stipulation being that it must be ‘fair’ and published. You’ll be notified of your CCG’s deadline in their decision letter to you.

Clarity but concern

The issue of appeal deadlines has been a bit of a grey area. The rules were set in 2012, but they weren’t published in the National Framework, or its 2018 update.

In October 2019 we received confirmation by the Department of Health and Social Care that CCGs now are free to make their own rules.

While clarity on this issue is welcome, we fear that the policy will lead to even greater gaps in practice across the country.

Postcode lottery

Despite the rules previously stating six months, CCGs have adopted varying approaches to appeal deadlines for some time.

In some areas, people are given just two weeks from the date of their decision letter to request an appeal. While in other areas, people have the recommended six months.

Beacon’s Managing Director, Dan Harbour, says:

“What we fear from this policy is that it will lead to more inconsistencies in appeal procedures across the country.

“To understand a CHC eligibility decision and decide whether to appeal, people might have a 50-page Decision Support Tool and many more pages of written evidence to get to grips with. Some of our callers and clients are given just two weeks to do this and prepare their grounds for appeal. How can that be reasonable?

“We urge CCGs to be fair to people when setting these deadlines. Allow people enough time to take in the information, and to seek help to understand it if necessary. Given time to develop a thorough understanding, many people will decide not to appeal. Those who decide to appeal need time to clearly articulate their grounds and rationale in writing – a clarity that will help the Local Resolution process.”

How we can help

Our free Navigational Toolkit contains a comprehensive guide to appealing a full assessment decision. Register and download your Toolkit today.

If you need a quick guide to help you decide whether to appeal, our blog is a great place to start.

We have an Expert Analysis Service, which provides a comprehensive review of your assessment and eligibility decision, with honest opinion on your likely chance of a successful appeal.

Or you can opt for Full Appeal Management, if you have already decided to appeal and need help and advocacy.